Oral health and dental conditions are critical to a person's functioning and well-being. Despite significant progress in reducing dental problems and oral diseases through adoption of safe and effective preventions, dental problems and oral diseases are still very prevalent, significantly affecting health-related quality of life. In the erly life cycle, children and adolescents are particularly vulnerable; they have either primary teeth, a mix of primary and permanent teeth or have just gotten permanent dentition, but are exposed to drinks and foods that are high in sugar and carbohydrates which are the primary causes of dental problems with long-term impacts throughout their life course. Although clinically-based health outcomes are objective and often used as gold standards, patient-reported outcomes (PROs) are first-hand feeling and perceptions about health that reflect what is most important to patients. Self-reports are efficient and are more cost-effective than clinical examinations or laboratory tests. The Patient-Reported Outcomes Measurement Information System (PROMIS(R)) was developed to create item banks that offer the potential for efficient, flexible and precise measurement. Despite the fact that many oral health surveys exist, they are limited by lack of systematization, precision, effectiveness, standardization and comparability across studies and diseases. To date, there are no existing oral health item banks available, nor are there associated short and long forms for measuring oral health. We propose to use state-of-the-science PROMIS qualitative and quantitative approaches to develop the first oral health item banks that can be used by oral health professionals, researchers and policy makers to effectively measure oral health outcomes among children and adolescents, ages 2-17 years (grouped as 2- 7, 8-13 and 14-17 years.) Specifically, we will (1) use existing PROMIS methodologies to develop oral health item banks and effective short and long forms to fill the gap in the PROMIS item bank systems; (2) calibrate and evaluate the acceptability, reliability and construct validity of the oral health item pool, and assess the short and long forms with randomly selected 600 children and adolescents from 15 diverse dental sites; and (3) link items in oral health banks with clinically determined and legacy oral health and general health measures, and estimate minimally important differences and responsiveness to change over time. With rigorous study design and analytical methods, these aims will be accomplished through four clearly defined operational phases: (I) literature review and evaluation of the relevance of PROMIS to oral health; (II) focus groups, cognitive interviews, and final item selection; (III) field testing of survey and clinical examination; and (IV) evaluation, including statistical and psychometric analyses, of the oral health items. The oral health items banks and short and long forms developed from this project can be used by licensing agencies, Medicaid programs, community clinics and private practices, and oral health researchers and professionals for oral health screening, quality of care assessment, oral health program evaluation and policy planning. 1